what this law does and what i think a growing consensus even in the private sector outside the law acknowledges is that if we are really going to make a difference in the new health paradigm, we have got to come to the bottom of the pyramid and recognize that is where the efficiencies are. putting greater emphasis on wellness and less on illness at the top of the pyramid not only produces better results, but costs less money. it isn't that it has to be either or. our goal is to cover the entire pyramid. putting the balance where it really needs to be with a far greater emphasis and reliance on bottom of the pyramid care than we ever had in history. this law begins to do that but it is going to take a lot of additional effort. the eerie medical school is here and we were talking before about the emphasis on internal medicine and the need for more primary care. i was just delighted to hear that they are one of the top schools in the country now in offering good primary care education and internal medicine opportunities. i believe it is coming. it is a crass expression, but i think it is true, you